The principles and practice of ophthalmic medicine and surgery / By T. Wharton Jones. With one hundred and ten illustrations.

  • Jones, Thomas Wharton, 1808-1891.
Date:
1856
Catalogue details

Licence: Public Domain Mark

Credit: The principles and practice of ophthalmic medicine and surgery / By T. Wharton Jones. With one hundred and ten illustrations. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    be permitted to touch the eyes of a patient, before the surgeon has made his examination. The surgeon should, in succession, glance at the eyebrows and orbital margins, the eyelids and their movements, the borders of the eyelids and state of the eyelashes, and the corners of the eyes, noting the presence or absence of lacrymation. He should then pass in review the form and appearance of the eyeballs generally— their size and degree of prominence—movements and direction— the correspondence of their axes—the appearance and color of' the white of the eye—the aspect of the cornea—the color of the iris— and the state of the pupil. The general bearing of the patient, and the expression of his features, should not be left unobserved. The information thus ob- tained, will sometimes reveal the nature of the case, or will guide in the further exploration of it. By the general bearing of the patient, and the expression of his features, it will be seen, for ex- ample, if he is affected with intolerance of light—if he be blind from amaurosis, or blind from cataract. The patient, intolerant of light, keeps his head bent down, and covers his eyes with his hands, in order to protect them from the light [or hides his head in a pillow or the bedclothes, or seeks the darkest corner of the room]. The eyelids are spasmodically closed, and at the same time the eyebrows ai*e knit and depressed, and the cheeks drawn up so that there is great distortion of the whole features. There is greater or less lacrymation. Whilst the confirmedly amaurotic patient moves about with an air of uncertainty, his head erect, and the eyes wide open—not converged and fixed on any object, but staring forward as if on vacancy—perhaps moving about in a vacillating manner, or squint- ing, the cataractous patient is more steady in his gait; and with his head bent forwards, his eyes half-closed, his eyebrows knit and de- pressed, he moves and directs the eyes naturally and steadily, in an exploratory manner. This survey, constituting the first step in the objective explora- tion of the eyes, may be taken during the time the patient is com- ing into the room, and relating the history of bis case. In the subsequent steps of the objective exploration, attention should be carefully directed to the relations which may exist between the ap- pearances observed and the patient's sensations—pain, tolerance or intolerance of light, and state of vision as elicited in the subjective exploration. Most probably the general objective survey, now indicated, in conjunction with the subjective examination, to be spoken of by- and-by, will direct the practitioner to the seat of the disease. On this part he will accordingly fix his attention, and subject it to the